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A Freely Movable Subcutaneous Nodule on the Dorsum of the Hand—Diagnosis
Arch Dermatol. 2004;140:1003-1008.
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Diagnosis: Palisaded encapsulated neuroma (PEN) (solitary circumscribed neuroma), subcutaneous variant.
MICROSCOPIC FINDINGS AND CLINICAL COURSE
Histopathologic examination of the enucleated subcutaneous nodule revealed a well-encapsulated mass composed of interlacing fascicles of spindle cells. The nodule was composed of multiple lobules that were incompletely separated by dense fibrous collagen bands. In some areas, the fascicles were loosely arranged, mimicking neurofibroma. A fibrous capsule composed of flattened, elongated cells was present around the nodule. The tumor cells were positive for S100 protein and vimentin and negative for  -smooth muscle actin. On immunohistochemical analysis, the cells of the capsule were positive for epithelial membrane antigen.
The patient was well and without recurrence 8 months after the procedure.
DISCUSSION
Palisaded encapsulated neuroma is a benign neural neoplasm that is found in both sexes, predominantly during middle age.1 It appears almost exclusively on the face.1-2 However, it is rarely found in other locations, such as the glans penis, oral mucosa, neck, shoulders, upper part of the arms, trunk, feet, and nasal . . . [Full Text of this Article]
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Arch Dermatol. 2004;140(8):1003-1008.
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